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12 Clinical Gems for Treating Hip Pain

From Dr Alison Grimaldi, physiotherapist of 30 years, researcher and educator

Provided as a Christmas Gift for 2020 and with best wishes to all for 2021

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Make sure you listen

Time is certainly an important confinement within which health professionals must work. How long do you allow for an initial assessment? 30mins? 45mins? an hour? more? ... This information may be critical to both your diagnosis and management success.

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Use a test battery

If there’s one thing we’ve learnt from the literature, it’s that when making a clinical diagnosis, there is very rarely a ‘sure thing.’ ... So, do we abandon clinical testing and provide a generic intervention for ‘non-specific hip pain’? … I hope I just heard a resounding ‘NO’!

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Take the time to explain

The foundation of a shared-decision-making-model is that the patient understands the situation, the choices and the advice provided. Developing this understanding usually involves answering 3 key questions – What? Why? and How?


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Posture – Change the dialogue

Let’s change the dialogue with our patients and with our colleagues, to find a way forward that does not deny the importance of controlling sustained loads in musculoskeletal conditions but also does not sentence our patients to a lifetime of chasing the enigma of ‘good posture’.

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Watch that stride length

How often have you seen patients who've developed anterior hip pain after taking up ‘power walking’ or walking with taller/faster walkers? The good news is, simple advice around reducing stride length can often have a rapid and marked impact on pain. Useful cues to reduce hip loads and hip pain in walking and running ...

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Use a cushion

An inability to sit comfortably can have a profound impact on quality of life. Different cushions can help those with differing conditions reduce hip and pelvic pain in sitting. These are the cushions we recommend for our patients ...

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Ban the Clam!

The ‘clam’ or ‘clamshell’ exercise has become an iconic exercise for gluteal and specifically for gluteus medius conditioning. In this blog, I will focus on a couple of good clinical reasons why you shouldn't prescribe the clam.

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Don’t forget the hip flexors

So often the focus is on the posterior and/or lateral elements of the muscular support system for the hip... Yes, it's very important to address impairments in gluteus maximus and the hip abductor muscle synergy, but don't forget the hip flexors. Find out why ...

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But please stop stretching!

Those hip flexors, at least ... Plenty of patients present with reduced hip extension range of motion, but for those with anterior hip pain, prescribing stretches may be counter productive. Let's take a look at why...

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HIP TIP # 10

HIP TIP # 11

HIP TIP # 12

Set goals

How many patients have you seen that are completely engaged at that initial assessment, get some moderate relief in the first few sessions ... and then just disappear. Weren't they happy with the progress?  This is where some good goal setting assists in ...

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Measure outcomes

High-quality standardised measures allow us to compare outcomes not only across time for an individual but benchmark important features of health against others. In this blog, we look at a great framework for measuring outcomes and some tools specific for measuring outcomes of treatment of hip and groin pain.

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Keep learning!

By arming ourselves with a good foundation of knowledge, enhanced with a healthy dose of clinical reasoning, we provide ourselves the best opportunity to provide a high-quality, evidence-informed approach to management of musculoskeletal pain. In this blog, I ask you to reflect on your own journey of professional development and provide a range of PD tips.

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